.address-autocomplete_panel__3J8qN{position:fixed;z-index:12000;overflow:hidden;border:1px solid #cbd7e2;border-radius:12px;background:#fff;box-shadow:0 16px 42px rgba(21,45,70,.2)}.address-autocomplete_status__47Y50{padding:12px 14px;color:#627182;font-size:.84rem}.address-autocomplete_option__d4HSd{display:block;width:100%;border:0;border-bottom:1px solid #edf1f4;padding:11px 13px;background:#fff;color:#173a5e;text-align:left;font:inherit;cursor:pointer}.address-autocomplete_option__d4HSd:last-of-type{border-bottom:0}.address-autocomplete_optionActive__18bJu,.address-autocomplete_option__d4HSd:hover{background:#edf5fb}.address-autocomplete_option__d4HSd strong{display:block;font-size:.9rem;line-height:1.35}.address-autocomplete_option__d4HSd small{display:block;margin-top:3px;color:#657585;font-size:.78rem}.address-autocomplete_source___YIrv{padding:7px 12px;background:#f5f7f9;color:#75818d;font-size:.7rem;text-align:right}@media(max-width:640px){.address-autocomplete_panel__3J8qN{left:8px!important;right:8px!important;width:auto!important}.address-autocomplete_option__d4HSd{padding:13px}.address-autocomplete_option__d4HSd strong{font-size:.94rem}}:root{--navy:#16324f;--navy-dark:#0d243a;--blue-soft:#eaf1f7;--orange:#ef7b32;--surface:#ffffff;--background:#f4f6f8;--border:#d9e0e7;--text:#15202b;--muted:#66717c;--success:#176b45;--danger:#8a3d2f}*{box-sizing:border-box}body,html{background:var(--background)}body{margin:0;color:var(--text);font-family:Arial,Helvetica,sans-serif}button,input,select,textarea{font:inherit}button{cursor:pointer}button:disabled{cursor:not-allowed;opacity:.45}.internal-navigation{position:fixed;z-index:50;right:18px;bottom:18px}.internal-navigation a{display:inline-flex;align-items:center;min-height:48px;padding:12px 16px;border-radius:999px;color:white;background:var(--navy);box-shadow:0 10px 28px rgba(13,36,58,.24);font-size:.86rem;font-weight:800;text-decoration:none}.internal-navigation a:hover{background:var(--navy-dark)}.app-shell{width:min(100%,760px);min-height:100vh;margin:0 auto;padding:20px 16px 92px}.topbar{display:flex;align-items:flex-start;justify-content:space-between;gap:16px;margin-bottom:18px}.eyebrow{margin:0 0 4px;color:var(--orange);font-size:.75rem;font-weight:800;letter-spacing:.12em}h1{margin:0;font-size:clamp(1.75rem,7vw,2.4rem)}.source-badge,h1{color:var(--navy)}.source-badge{flex:0 0 auto;padding:8px 10px;border-radius:999px;background:var(--blue-soft);font-size:.76rem;font-weight:700}.form-card,.progress-card{border:1px solid var(--border);border-radius:18px;background:var(--surface);box-shadow:0 8px 30px rgba(22,50,79,.07)}.progress-card{padding:14px 16px;margin-bottom:14px}.progress-copy{display:flex;justify-content:space-between;gap:12px;margin-bottom:10px;font-size:.86rem}.progress-copy span{color:var(--muted)}.progress-track{height:7px;overflow:hidden;border-radius:999px;background:#e6ebef}.progress-value{height:100%;border-radius:inherit;background:var(--orange);transition:width .2s ease}.form-card{overflow:hidden}.form-section{display:grid;grid-gap:16px;gap:16px;padding:22px 18px}.section-heading{display:flex;align-items:center;gap:12px}.section-heading>span{display:grid;flex:0 0 38px;width:38px;height:38px;place-items:center;border-radius:12px;color:white;background:var(--navy);font-weight:800}h2{margin:0;color:var(--navy);font-size:1.2rem}.section-heading p{margin:4px 0 0;color:var(--muted);font-size:.85rem}label{position:relative;display:grid;grid-gap:7px;gap:7px;color:var(--navy);font-size:.86rem;font-weight:700}input:not([type=checkbox]):not([type=radio]),select,textarea{width:100%;min-height:48px;padding:12px 14px;border:1px solid var(--border);border-radius:12px;outline:none;color:var(--text);background:#fff;font-weight:500}input[type=checkbox],input[type=radio]{flex:0 0 auto;width:18px;height:18px;min-height:18px;padding:0;border:0;box-shadow:none;accent-color:var(--navy)}textarea{resize:vertical}input:not([type=checkbox]):not([type=radio]):focus,select:focus,textarea:focus{border-color:var(--navy);box-shadow:0 0 0 3px rgba(22,50,79,.1)}label small{position:absolute;right:14px;bottom:15px;color:var(--muted)}label:has(>input[name=withdrawalChoice])>span{min-width:0}label:has(>input[name=withdrawalChoice]) small{position:static;right:auto;bottom:auto;display:block;margin:0;color:var(--muted);font-size:.82rem;font-weight:500;line-height:1.45}.field-row{display:grid;grid-template-columns:.8fr 1.2fr;grid-gap:12px;gap:12px}.field-help{margin:-10px 0 0;color:var(--muted);font-size:.78rem;line-height:1.4}.segmented{display:grid;grid-template-columns:repeat(2,1fr);grid-gap:8px;gap:8px;padding:5px;border-radius:13px;background:var(--blue-soft)}.segmented-three{grid-template-columns:repeat(3,1fr)}.segmented button{min-height:42px;border:0;border-radius:9px;color:var(--navy);background:transparent;font-weight:700}.segmented button.active{color:white;background:var(--navy)}.choice-grid{display:grid;grid-template-columns:repeat(2,1fr);grid-gap:10px;gap:10px}.choice{display:flex;align-items:center;gap:9px;min-height:52px;padding:10px;border:1px solid var(--border);border-radius:12px;color:var(--navy);background:white;text-align:left;font-weight:700}.choice.selected{border-color:var(--navy);background:var(--blue-soft)}.check{display:grid;flex:0 0 28px;width:28px;height:28px;place-items:center;border-radius:9px;color:white;background:var(--navy)}.toggle-card{display:grid;grid-template-columns:auto 1fr;align-items:center;grid-gap:4px 10px;gap:4px 10px;min-height:62px;padding:10px 12px;border:1px solid var(--border);border-radius:12px;color:var(--navy);background:white;text-align:left;font-weight:800}.toggle-card.selected{border-color:var(--navy);background:var(--blue-soft)}.toggle-card .check{grid-row:1/span 2}.toggle-card small{color:var(--muted);font-size:.75rem;font-weight:500}.prescriber-selection{margin:-9px 0 0;padding:10px 12px;border-radius:10px;color:var(--success);background:#edf8f2;font-size:.8rem;font-weight:700}.prescriber-buttons{display:flex;flex-wrap:wrap;gap:9px;margin-top:-4px}.prescriber-buttons .secondary-action{flex:1 1;margin:0}.prescriber-editor{display:grid;grid-gap:15px;gap:15px;padding:16px;border:1px solid #cbd8e4;border-radius:14px;background:#f7fafc}.prescriber-editor-heading{display:flex;align-items:center;justify-content:space-between;gap:12px;color:var(--navy)}.prescriber-editor-heading button{display:grid;width:32px;height:32px;place-items:center;border:0;border-radius:9px;color:var(--navy);background:var(--blue-soft);font-size:1.3rem}.prescriber-editor .field-help{margin-top:-7px}.summary{display:grid;grid-gap:1px;gap:1px;overflow:hidden;border:1px solid var(--border);border-radius:14px;background:var(--border)}.summary div{display:grid;grid-gap:4px;gap:4px;padding:14px;background:white}.summary small,.summary span{color:var(--muted);font-size:.78rem}.summary strong{color:var(--navy)}.pricing-breakdown{display:grid;grid-gap:1px;gap:1px;overflow:hidden;border:1px solid var(--border);border-radius:14px;background:var(--border)}.pricing-breakdown>div{display:flex;justify-content:space-between;gap:16px;padding:11px 14px;background:white;font-size:.86rem}.pricing-breakdown strong{white-space:nowrap;color:var(--navy)}.pricing-breakdown .discount-line strong{color:var(--success)}.pricing-breakdown .recommended-line{padding-block:14px;color:var(--navy);background:var(--blue-soft);font-weight:800}.pricing-breakdown .recommended-line strong{font-size:1rem}.warning-list{padding:10px 14px;border-radius:12px;color:var(--danger);background:#fff0eb;font-size:.82rem;line-height:1.4}.warning-list p{margin:4px 0}.price-input{padding-right:42px;font-size:1.15rem;font-weight:800}.final-total{display:grid;grid-template-columns:1fr auto;grid-gap:4px 16px;gap:4px 16px;padding:17px 16px;border-radius:14px;color:white;background:var(--navy)}.final-total span{align-self:center;font-weight:700}.final-total strong{font-size:1.55rem}.final-total small{grid-column:1/-1;color:#dce7f0;font-size:.74rem}.notice{padding:12px 14px;border-radius:12px;color:#725019;background:#fff4d9;font-size:.82rem;line-height:1.45}.error-message,.success-message{margin:0;font-weight:700;text-align:center}.success-message{color:var(--success)}.error-message{color:var(--danger)}.download-link{display:grid;min-height:50px;place-items:center;padding:12px 18px;border-radius:12px;color:white;background:var(--success);font-weight:800;text-align:center;text-decoration:none}.download-link:hover{filter:brightness(.96)}.form-actions{display:flex;justify-content:space-between;gap:12px;padding:16px 18px;border-top:1px solid var(--border);background:#fafbfc}.primary-action,.secondary-action{min-height:48px;padding:12px 18px;border-radius:12px;font-weight:800}.primary-action{margin-left:auto;border:0;color:white;background:var(--orange)}.secondary-action{border:1px solid var(--border);color:var(--navy);background:white}.full-width{width:100%;margin-left:0}@media (max-width:480px){.internal-navigation{right:10px;bottom:10px}.internal-navigation a{min-height:44px;padding:10px 14px;font-size:.8rem}.app-shell{padding-inline:10px}.topbar{align-items:center}.source-badge{max-width:120px;text-align:center}.field-row{grid-template-columns:1fr}.choice-grid{grid-template-columns:1fr 1fr}.form-section{padding-inline:14px}.prescriber-buttons{flex-direction:column}}